Community learning disability nursing

2014 ◽  
pp. 221-237
Keyword(s):  
Learning Disability ◽  
Community Learning

scholarly journals Transfer and transition referrals of patients with intellectual disability from children's services to adult community learning disability teams

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S103-S103
Author(s):  
Jalil-Ahmad Sharif
Keyword(s):  
Intellectual Disability ◽  
Learning Disability ◽  
Psychotropic Medication ◽  
Limited Information ◽  
Children's Services ◽  
Term Care ◽  
Community Learning ◽  
Children’S Services ◽  
Support Plan ◽  
Transition Support

AimsThe audit aimed to assess if patients under the care of children's services in Wessex were transferred at the appropriate age and whether transition referrals to Community Learning Disability teams (CTLD) occurred timely. It also aimed to look at how many patients underwent transitions in a three month period, and if their transition support plan (TSP) was completed. A transition support plan should include chronological information on psychopharmacology, psychotherapy, and social support measures. Patients should be referred between the ages of 17–19 but require a justification after 18 years of age.MethodThe BI team was contacted to provide all IDs for patients referred within a three month period between the ages of 17–19. The BI team provided 42 patients with their ID. Patients discharged from services within a short time span were excluded for the following reason: inappropriate referral (9pts), discharged after 1st assessment (6pts), internal discussion (6pts), only referred to Autism team (4pts), moved out of area (1pts). From the initial 42 patients, 16 patients were analysed using the collection tool.Result4/16 had a TSP, and only two had a complete TSP and transitioned in another trust and were inter-team referrals.CAMHS services referred 1/16 patients.Psychotropic medication was prescribed to 12/16 prior to or on time of referral, but only two patients had a complete psychotropic medication history.8/16 patients' referral was commenced prior to their 18th birthday, and no information was provided for delay in transfer.Health records did mention psychotherapy, but apart from 2/16 TSP records, no additional information was available on the modality.ConclusionPatients with Intellectual Disability face challenges when transferring from children to adult services. Insufficient referral information may have a detrimental impact on patients wellbeing and long-term care.Access to a patient's chronological journey through the different children's services allows Adult CTLD health professionals to provide effective care. Historical psycho-social and pharmacological interventions provide a reference point for future interventions.Concerns included: limited information on most TSP regarding psycho-social and psychotropic treatments, lack of access to CAMHS/CHYPS paperwork and ineffective inter-trust communication for transition patients.This project highlighted the average number of transition cases in 3 months. It led to changes to the transition pathway, as awareness was raised in trust and CCG meetings to improve patient outcome. CTLD created the new role of transition facilitators to support children's services. They sit in meetings before patients transition referrals.

scholarly journals Service provision in Scotland for people with an intellectual disability who have, or are at risk of developing, dementia

Dementia ◽  
2018 ◽  
Vol 19 (3) ◽  
pp. 736-749 ◽  
Author(s):  
Karen McKenzie ◽  
Dale Metcalfe ◽  
Amanda Michie ◽  
George Murray
Keyword(s):  
At Risk ◽  
Intellectual Disability ◽  
Learning Disability ◽  
Service Provision ◽  
Disability Services ◽  
Health Board ◽  
Common Elements ◽  
Online Questionnaire ◽  
Community Learning ◽  
Direct Assessment

This research aimed to identify current national provision by health services in Scotland in relation to proactive screening and reactive assessment for people with an intellectual disability in Scotland who have, or are at risk of developing, dementia. Staff from 12 intellectual disability services, representing the 11 health board areas in Scotland, completed an online questionnaire which asked about proactive screening and reactive assessment for people with intellectual disability who had, or were at risk of developing, dementia as well as suggested areas for improvement. All of the areas provided services for people with intellectual disability who have, or are at risk of developing, dementia, but differed as to whether this was reactive, proactive or both. Nine services offered intervention following diagnosis. The most common elements used across both proactive screening and reactive assessment were conducting a health check, using a general dementia questionnaire designed for people with an intellectual disability and direct assessment with the person. Clinical psychology and community learning disability nurses were the professions most likely to be involved routinely in both proactive screening and reactive assessments. The psychometric properties of the most commonly used assessments of cognitive and behavioural functioning were mixed. The areas of improvement suggested by practitioners mainly related to ways of improving existing pathways. This research represents the first step in providing an overview of service provision in Scotland. There was some inconsistency in relation to the general and specific components which were involved in proactive screening and reactive assessment. Implications for service provision are discussed.

Community learning disability teams: the need for objective methods of prioritization and discharge planning

2002 ◽  
Vol 15 (4) ◽  
pp. 223-233 ◽  
Author(s):  
Anna Caffrey ◽  
Margaret Todd
Keyword(s):  
Mental Health ◽  
Learning Disability ◽  
Discharge Planning ◽  
Evidence Base ◽  
Planning System ◽  
Community Learning ◽  
Referral Criteria ◽  
Formal Mechanism ◽  
Health Domains ◽  
Do So

As part of caseload management for community learning disability teams (CLDTs), it would appear reasonable that services would have a mechanism for prioritizing referrals and discharge planning. However, any formal mechanism in relation to these two aspects apparently is lacking within the literature. This theoretical article attempts to illustrate this evidence-base need, and demonstrate how a prioritization and/or discharge planning system would aid CLDTs. In light of the scarcity of material for the learning disability sector, information has been examined from other health domains such as mental health. The paper also presents a discussion on whether rationing of services is best done via explicit or implicit means. Issues related to setting referral criteria and the allocation of referrals are also considered. Although suggestions have been made for CLDTs, it is difficult to do so whilst the evidence base for this sector is so lacking.

scholarly journals Audit of the use of psychotropic medication for challenging behaviour in a community learning disability service

2004 ◽  
Vol 28 (12) ◽  
pp. 447-450 ◽  
Author(s):  
Tom Marshall
Keyword(s):  
Side Effects ◽  
Learning Disability ◽  
Psychotropic Medication ◽  
Evidence Base ◽  
Challenging Behaviour ◽  
Duration Of Treatment ◽  
Community Learning ◽  
Disability Service ◽  
People With Dementia ◽  
Multiple Drugs

Aims and MethodThe aims of the study were to identify patients in a community learning disability service receiving psychotropic medication for challenging behaviour, to examine prescribing practice and to compare this against local consensus standards. Local consensus standards were agreed by the consultants and the notes were reviewed by the author.ResultsA total of 102 patients were identified as receiving psychotropic medication for challenging behaviour (26.7% of notes examined). The most common additional diagnoses were autism (29%) and epilepsy (28%). The average duration of treatment was 5.3 years, and multiple drugs were used in 34% of these patients. Antipsychotics were the most commonly used drugs (96% of patients). There was rarely a detailed description of the challenging behaviour. There was little regular monitoring of side-effects or warning about potential side-effects when the medication was started.Clinical ImplicationsChallenging behaviour is a common cause of multiple prescribing in learning disability patients, and is often long-term in the absence of a strong evidence base. Other specialties use medication to control disturbed behaviour, particularly in people with dementia or personality disorder, so this audit may also be of interest to old age, adult and forensic psychiatrists.

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